7/28 Shasta AMPS=255 PMPS=302 +2=383 +4=280 eating some; walking some; very drugged

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Deborah & Shasta

Deborah & Shasta

Member Since 2012
7/27 Shasta

WCR: A few Ps in place. Little girl isn't feeling well, at all today. Barely ate any of her breffis; barely ate any of her next two breffises; vomited clear liquid at +3; will eat little bits of Pill Pockets; sprawled out on floor... and I had to leave her for 2 hours to go for my dentist appointment (first time w/ new dentist.) On the way to the dentist, I stopped by vet (2 blocks from each other) and talked to the receptionist and told her everything. Also, I told her the "suggested" medications (not that I'm trying to tell my vet how to do his job, but I don't want him to keep dismissing Ondansetron just because he's never used it and two textbooks say that it's for felines with cancer!) When I look at Marje's Primer on Pancreatitis post, Shasta easily fits into almost every symptom:

Symptoms
Cats with pancreatitis, even when severe, often present with non-specific clinical signs. In one study of 40 cats with severe pancreatitis the following clinical signs were reported:
• lethargy (100%)
• anorexia (97%) waistline is very skinny.
• dehydration (92%) drinking much more water lately
• hypothermia (68%)
• vomiting (35%)
• abdominal pain (25%)
• a palpable abdominal mass (23%) I think she has a palpable mass, but it might be because she's so skinny and her ribs/abdomen is so prominent.
• shortness of breath (dyspnea) (20%)
• loss of muscle coordination (ataxia) (15%) <- wow, this morning was pretty noticeable.
• diarrhea (15%) <- opposite, she's constipated.

In diabetic cats, BG levels often increase possibly in response to pain but also inflammation.

Her coordination was all over the place this morning. She's able to walk, and jump (mostly by pulling herself up), but when I tried to hold her on the tile area (thought she was going to be sick again), her back legs just kept slipping out from under her and she kind of kept falling over. It's the worst I have ever seen her.
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When I left for the dentist, she was sprawled out on the floor looking wretched. I hate myself for leaving her.

I just got her to eat a little Fancy Feast T&G and she's resting on her window bed. I'm waiting to hear back from the vet's office. Yes, I'd love to not have to take her in, but I have her crate ready and can be there in 5 minutes top. Until then, I'm going to sit here and worry...obsessively.
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Sending healthy vines to all our sugar kitties and their hoomins! Blessings!

~Deborah & Shasta


AMPS=255 (13% FF Grilled Chicken in Gravy)
+2=215
+3=vomit clear liquid; lack of muscle coordination
+4=156
+6.5=106 (3% FF T&G 1oz)

+11.5= 1/4 tab Cerenia; .04mL Bupe
PMPS=302 (13% FF Grilled Chicken in Gravy 1oz w/ Zobaline)
+2=383
+4=280 (13% FF Grilled Chicken in Gravy w/ 1/4 PotassiTab)
+5.5= (3% FF T&G 1oz & Zobaline)

Poo Pee tally
Pee piles - 2
Poo piles - 1 (am - small - took in for fecal float)
 
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Deb, have you had your vet run the Spec fPL test? It will show if this is pancreatitis. If there is a mass that would likely be something else I fear. Ondansetron is a good drug.
 
Hi Elise,

Thanks for checking in on us. We haven't done blood work since late March. Shasta is the nastiest cat while at the vet and they have to sedate her. We try to avoid those situations due to the stress and fear of not coming out of sedation, but I've already told them that I'm willing to haul her over the right now and sit on her while they draw blood. As for the mass, I don't necessarily think it's a mass. I think it's because she's lost weight and her waistline is fairly prominent and that makes her ribcage look extra wide...whereas it didn't look so disproportional a week(s) ago.

I've asked my vet about Ondansetron before. He said that he had never used it and he did a quick check, came back and said that it was used specifically for cats with cancer and he has other anti-nausea meds that he prefers. When I talked to the receptionist/vet assistant this morning, I mentioned both the Ondansetron and Cerenia. She had never heard of the Ondansetron, but they had several patients on Cerenia. I mentioned that a lot of the FDMB people that I'm in contact with used both because the Cerenia is a 5 consecutive day max. kind of drug and after 5 days, people would switch to Ondansetron. She said that some of the patients use it for a little more than 5 consecutive days and it's ok. Again, that's fine, but if Shasta makes it through all of this and needs these drugs often...I don't want to push my luck with the Cerenia and 5 consecutive days. <sigh> I just want her feeling better.
 
If you google the IDEXX pancreatitis article which might be in the handbook you can Xerox the pages when ondansetron is specifically mentioned. Cerenia no longer requires a holiday either. Let me see if I can find a link for you.

Also don't let him run the in house Snap test. It just gives a positive or negative and the requires the Spec fPL. BRB if I can get you a link to a good article.

Here you go.
https://ca.idexx.com/pdf/en_ca/smal...ng-pancreatitis-and-concurrent-conditions.pdf
 
So, I just heard back from the vet assistant and my vet prescribed Simbadol for pain and Cerenia for nausea. I'm a bit concerned about him prescribing the Simbadol and not Bupe, but she just called back as I was typing and told me that the Simbadol is the same thing as Bupe. Is this right? I haven't had a chance to check. They close in 30 minutes and I want to get up there before they close.
 
Thank you, Carla & Chris & Amy. I am home with her drugs. Are these doses ok? They did say that if Shasta seems overly sedated from the Bupe to discontinue. Do I need to give them at particular times or just give NOW!?! Thanks, thank you, thanks a million!!!

The Bupe is to be administered orally - .04mL every 12 to 24 hours; Cerenia (16mg) - give 1/2 tab orally every 24 hours.
 
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Simbadol is a long acting form of buprenorphine. Typically, bupe is dosed 2 - 3 times a day. Simbadol is a once a day dose. HOWEVER, it also contains anhydrous dextrose. which is sugar and may raise BG numbers. (I can't find any info on it being contraindicated in diabetic cats, though.) It shouldn't be used for more than 3 days and is injection only. The human form of bupe, which is what we've been using, could be given as an oral liquid.
 
{{{Deborah}}}

I'm so sorry Shasta is feeling so unwell. If it is P-titis, they usually give something for nausea and something for pain, which is what your vet has done. I give Cerenia in 1/4 tab doses. You might try starting with that. It's hard to get them exact, as it's a small pill to start with, but it's okay if it's not perfect. I'm not sure about the .04 for the Bupe. Minka, who weighs about 8 lbs, gets .1 ml every 8 hours as needed.

Sending tons of healing and appy vines. And :bighug:
 
Thank you, Sienne & Tricia. I think I'll start with the 1/4 tab Cerenia, but I'm so concerned about the Bupe. The container that they put the Bupe syringes in says "Buprenorphine" (not Simbadol), but I'm wondering if she put that name on it because she heard the panic in my voice. The Bupe is oral injection, but instead of 2-3 times a day, the instructions do say every 12-24 hours, as needed. UGH!
 
Deborah & Shasta said:
but when I tried to hold her on the tile area (thought she was going to be sick again), her back legs just kept slipping out from under her and she kind of kept falling over. It's the worst I have ever seen her.
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This is worrisome to me. Alex had p-titis... sometimes her bouts with p-titis were severe and yet she never had trouble walking nor did she fall over.

I understand not wanting to take her to see the vet. I took Alex only when absolutely necessary because she transformed herself into Cujo kitty the minute we arrived and had to be sedated more often than not, but like Amy, I do think she needs to be seen. I think it would be a good idea to make sure there's nothing else going on.

Just my thoughts...

:bighug::bighug::bighug:
 
She was unsteady in her hindquarters starting this morning. It's gotten worse throughout the day. She's able to walk & jump up via steps (all unsteady, but capable). She just received her first dose of Bupe and Cerenia. She hasn't gotten much Zobaline recently because she started rejecting the food with Zobaline in it. When I picked up her meds this afternoon, I told the vet assistant that they shouldn't be surprised if I show up at their doorstep first thing in the morning. She said that she would leave them a note so that they weren't blindsided! o_O
 
Sounds like Alex and Shasta are very similar at the vetty...The Devil's Spawn is another good nickname for her. My goal is to be at the vet's office before 7:30am. Vet doesn't actually show up until 8am, but that should guarantee that we are seen early. She's hurting, so that's going to make her a pain in the butt. However, she may just be too worn out to fight much. :(
 
I am no expert but is Shasta dehydrated?
With vomiting, her electrolytes could be out of balance and the unsteady back legs she has could be from low potassium levels which if found to be so, can be corrected with medication. I think it would be worth checking that out.
 
Thank you, Tricia, Jill, Bron, Liz & Wendy.

Tricia, I'll give her Bupe before we go...definitely.

Bron, most likely, she is dehydrated. She's been drinking lots of water, on her own; she got 100mL sub-q fluids on Saturday. I'm worried about "overdoing" the sub-q fluids because of a potential heart problem that was never officially diagnosed. <sigh> She was on Potassium supplements for a while, but again, since I can't take her to the vet often (Tasmanian Devil comes alive inside of her!), I worried about over supplementing her K. Her last blood work in March showed that she was ok, but I won't be surprised if she is back to being low. If they can draw blood tomorrow (versus her drawing blood from us), I hope it answers all these questions. Thank you.

Thank you all for the healing vines and support. I'm sorry that I haven't been on the board much...until I need something. What a horrible person I am. I've really been trying to snuggle more, pet more, love more...worry less. Worrying less is not easy. :( So thank you for being here for us and lending your ears & eyes and giving support and advice. :kiss:

p.s. She did eat the majority of her dinner (about .75oz FF Grilled Chicken in Gravy w/ Zobaline) :joyful:
 
Piling on more vines! How worrisome! I gave punkin the injectible bupe because I thought it would be more reliably dosed than giving it orally, then I read somewhere that it's absorbed better given orally. Maybe not enough to make a significant difference, but if it is pancreatitis and you are going to continue the bupe, you might consider getting it orally instead. It's very easy to squirt up on the gums or in the cheek pocket and it apparently absorbs very quickly.

Hope that she responds quickly and you've got a healthier, happy kitter very soon.
 
julie & punkin (ga) said:
Maybe not enough to make a significant difference, but if it is pancreatitis and you are going to continue the bupe, you might consider getting it orally instead.
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Thank you, Julie! The Bupe that I have for Shasta is in oral form. She wasn't happy about it, but I didn't really care!!! Thanks for some good info.
 
That is interesting she has already needed the potassium. I am glad you are getting blood tests tomorrow. I would not give any potassium now though until you find out, as it could be dangerous if the levels are OK and she had more. You probably know this already I am sure! Good luck. It is always such a worry when they are sick!:bighug:
 
Thank you, Bron. I feel like I live in a constant state of worry and fear because I don't know what's ailing her and I can't fix it. But she just took care of my when I was sick, so time for me to do the same...even though she'll hate me for taking her to the vetty. :blackeye:
 
Stacking on more vines for dear Shasta. With the Bupe you do want to make sure that it hits the inside of the mouth somewhere rather than goes straight down the hatch or it won't be so effective :bighug::bighug::bighug: I understand about the vet, Vyktor is the same. He goes so beserk that his gums start turning blue and the vet worries he's going to have a heart attack. Why do you have to make it so hard kitties :(
 
I forgot to add, it's a good thing you got the liquid bupe instead of the injections. From the 2015 AAFP/AAHA pain management guidelines for cats and dogs,
In cats, the subcutaneous (SC) route of opioid administration is not recommended. intramuscular (iM) and intravenous (iV) routes are preferred both pre- and postoperatively.15 The oral transmucosal or buccal route of administration for buprenorphine may have clinical efficacy as well
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Great information to know. Thank you, Wendy. She just ate a bit more and I just noticed the her "waistline" that was very distinct this morning/afternoon is not anymore. However, the Bupe is really wiggin' her out. I wanted her out in the tv room where I am, so I gently scooped her up and she started hissing at me and growling and looking like dragons were chasing her. Her eyes are FULLY DILATED! :eek: I see the opioid affects now. :oops: Maybe giving her second dose before the vet isn't such a good idea.
 
@Dyana , I did exactly that with the Cerenia. Instead of 1/2 tab, I gave 1/4 tab, but the Bupe was already in the syringes to be given orally and there was no way of only getting half into her mouth. I was just happy that I got any of it in her mouth with the fuss she was giving me. ;)
 
Deborah & Shasta said:
@Dyana , I did exactly that with the Cerenia. Instead of 1/2 tab, I gave 1/4 tab, but the Bupe was already in the syringes to be given orally and there was no way of only getting half into her mouth. I was just happy that I got any of it in her mouth with the fuss she was giving me. ;)
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Trix has a VERY hard time with bupe now (she was OK with it in the past). When she was on it last year, I would twist out part of the dose before giving it to her because a full dose had some really freaky side-effects (yep, I know what you're talking about). Even half a dose had some of the extreme loopiness, but it's a balancing act when they are in pain. It wasted a bit of bupe, but that was better than giving Trix a full dose.

I hope she continues to eat and regain her strength. If it is p-titis, fluids do play a very important role. With Trix, she normally gets 100mls every day, but when she's had flares, the vet has told us to increase to 150mls per day. So if you can get daily fluids going right now, it may very well help - although that is one thing to double-check with your vet before doing so.

Even more prayers coming your way!
 
Thanks, @Amy&TrixieCat. She's very loopy. I brought her out to the tv room and within about 10 minutes, she jumped down and want back into her little room to be by herself. :( However, it is dark in there, so maybe it's better on her very dilated eyes and she's not seeing as many shadows trying to eat her. :rolleyes: I may have to do what you did and twist some out next time. I'll talk to the vet about it tomorrow. I'm sure he'll be sooooo happy to see us first thing in the morning...NOT! :banghead:
 
Deborah, I have been away from the board for a week or so and am very sorry to hear that Shasta is not feeling well. I hope you can get her to the vet without her going beserk. Have you ever considered the Thundershirt?
http://www.thundershirt.com/thundershirt/thundershirt-cats.html

I hope that the meds situation can be straightened out and that Shasta will regain her strength and her appetite. The IDEXX round table on pancreatitis is excellent: I tried to send you a link to it, but I am using an old computer here at camp and the bookmark doesn't work. Check Marje's pancreatitis primer. I think the link to the IDEXX vets' round table is there.

Sending beautiful healing vines for Shasta and lots of hugs to you,

Ella & Rusty
 
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Thank you, Ella. I haven't tried the thundershirt. I think she'd kill me if I tried putting it on her! lol! We tried the CalmCollar a long time ago...yeah, that didn't help. I will go back and recheck Marje's post after my shower. I'm not recalling the IDEXX round table that you speak of. Thanks again for the vines and hugs. Hope you are having a good time at camp!
 
saw this earlier today and my first tho't was the potassium issue was back too.
Shadow wasn't able to do the normal dose , same issues ... dilation, agitation, pacing....( dysphoria)
I gave her 0.1 mL or 0.2 mL at most. Fortunately, I could load my own.

adding more vines....
 
punkin had a reaction like that to tramadol, but not to bupe. I would definitely reduce her dose and I wouldn't give it any earlier than it was prescribed. I gave punkin 0.2ml of the Bupe and he weighed about 14ish lbs at the time.

Didn't you say this is a long-lasting form of Bupe?

we gave Bupe to punkin for months for his arthritis from the acro.

We also gave him cerenia for many days in a row when it was needed, 1/4 tablet. That "take a break" on cerenia has been updated to reflect that it's ok to give it consecutively for more than 5 days.
 
Hi Deborah,

I've been gone most of the day and missed all of this. I hope Shasta is feeling better this evening.

My first though on reading the problem withe back legs was the potassium levels. I dealt with this with Mannie, his was very low, and that was what he did, wobbly, would fall over, lose his leg strength etc.

I too gave cerenia daily, not worries on the only 5 days thing. He tolerate that well.

The bupe was a guessing game for me. We started at the low end of the recommended dose and went from there, usually less than what was recommended. I could tell when it was too much as he was a zombie. He got just enough to take the edge off.

Many feel better vines for Shasta, Hugs to you.
 
Thank you, Chris, Marilyn, Rhiannon, Julie, Michelle & Josie.

I just got her to eat a little more FF Grilled Chicken in Gravy w/ 1/4 PotassiTab. I know her numbers are high, but every time I offer her a lower carb alternative, she licks her lips and turns away. She's still struggling with her hind end...very wobbly and very uncomfortable. Several times that I've watched her go to lie down, she attempts several positions, but just keeps walking in circles like it hurts to lay down...but she wants to lay down. I just went to check on her and she got up (apparently, I'm annoying her) and walked away and this time had no problem lying down a few feet away.

@rhiannon and shadow (GA) - I do believe this dose of Bupe is quite high for her. She's just under 8lbs now. :(

@julie & punkin (ga) - Sienne is the one that found the information on Simbadol being a longer acting form of Bupe. I'll ask the vet about it tomorrow, but I have no plans on giving her more until after I've seen the vet and we've done blood work (assuming Shasta will cooperate).

@Michelle and Mannie (GA) - I remember that we've talked about Mannie's Potassium issues. I just got her to eat fuds with 1/4 PotassiTab...here's hoping it helps. And great to know about the Cerenia because my vet is not interested in prescribing Ondansetron.

Thank you, again for all of your help, advice, support, kind words.
 
Well. I think we established that the Bupe doesn't calm her down! I wish I had something more to offer, suggestion-wise. I haven't been able to calm my anxious kitties when they travel, either, but luckily none of them go psycho when they get to the vet. Sending tons of calming vines for tomorrow - for both of you!
 
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